The recent experience with the 2009 H1N1 pandemic has drawn attention to the need to better understand the public’s response to emergently released vaccines (ERV). This study applied a mixed methods approach to examine the causal pathways underlying the vaccination behaviour during a public health emergency. The integrated evidence from empirical and theoretical-based findings highlights a number of factors to consider in interventions to improve vaccination rates with an ERV. These factors include: 1) providing clear risk messages around the disease and the ERV, 2) improving accessibility to the vaccine, 3) encouraging primary healthcare providers to provide recommendations for vaccination, 4) implementing strategies to increase seasonal influenza vaccination prior to the next public health emergency, 5) developing strategies to target sub-populations more reluctant to accept an ERV. Developing theory-based interventions that are behaviour-specific may be more likely to result in behaviour change within the public in future emergency vaccination campaigns.

2009年4月，墨西哥與美國西南地區出現人類感染A／H1N1新型流感病毒，此一新興傳染疾病在短時間內，擴散至全球各地。因媒體是社會大眾獲得健康風險訊息的主要來源之一，媒體呈現的H1N1新型流感樣貌，可能影響閱聽眾對此疾病的認知、態度，甚或行為。故本文研究目的有二，一為探討報紙媒體如何呈現H1N1新型流感新聞，分析新聞版面、性質、篇幅、主題、消息來源與圖表運用，二為檢視H1N1新型流感新聞內容是否聚焦風險不確定的面向，呈現公眾憤怨恐慌的要素，以及是否提供民眾評估風險的資訊。了解台灣報紙媒體如何呈現新流感相關議題，為國內媒體呈現傳染疾病的研究新增不同類型的個案。 本研究蒐集《中國時報》、《聯合報》、《自由時報》和《蘋果日報》，自2009年4月25日至2010年2月25日止，共1,324則H1N1新型流感新聞為樣本，採用內容分析法檢視四報H1N1新型流感新聞的特性與呈現的風險訊息。並依H1N1新型流感疫情發展分為五個階段，比較各階段報導呈現風險訊息之異同。 研究結果發現，主題分布依疫情階段而有顯著差異，雖「疫情現況」為各時期H1N1新型流感報導最常呈現的報導主軸，但各疫情階段報導的主題比例仍有不同，尤其疫情趨緩期的主題比重與其他時期差異較大。在主要消息來源方面，各疫情階段皆以「衛生單位官員」為最多，尤其至疫情趨緩期時，主要消息來源偏向更為明顯。 在報導呈現公眾憤怨恐慌的要素方面，以各時期呈現憤怨恐慌的要素總比例比較之，疫情升溫期呈現憤怨恐慌要素的比例為最多，至疫情高峰期與疫情趨緩期，呈現憤怨恐慌的要素之總比例則明顯減少。四報呈現憤怨恐慌的要素皆以「憤怨恐慌的修辭」為最多，高達近五成新聞出現「憤怨恐慌的修辭」要素。 在報導呈現風險解釋方面，以各疫情階段呈現風險解釋的總比例相比，疫情入台傳散期，報導呈現各項風險解釋的比例為最高，其次為疫情初始期，再次為疫情升溫期。四報呈現的風險解釋以「過程解釋」類訊息為最多，其次為「實用建議」類的訊息，而「定義解釋」、「風險程度」、「風險比較」類訊息則較少被提及。 報導圖表文字內容呈現方面，則發現除《蘋果日報》外，其他三報運用圖表的比重偏低，顯示H1N1新型流感報導運用圖表解釋風險仍不甚普遍。但包含圖表的報導，圖表文字多為「風險解釋」的訊息，常提及「過程解釋」與「實用建議」類資訊。研究也發現，新聞正文與圖表文字呈現相對應的風險解釋類型有顯著相關性，其中以新聞正文與圖表文字呈現「風險比較」的相關程度最高。 透過本研究分析發現，四報有部分報導凸顯風險不確定的面向，憤怨恐慌要素以「恐懼恐慌」、「疫情失控淪陷」、「衝突或矛盾」比例較多；在風險解釋呈現方面，則以「疫情數據資料更新」、「目前疫情傳佈範圍／地區」類的訊息為最多，「風險程度」、「定義」與「風險比較」等訊息則較少被提及。 假定報導提供風險解釋，可減少公眾因對風險的「不確定性」產生的憤怨恐慌，本研究發現提醒媒體實務工作者，記者在危機或風險事件發生，擔負風險溝通的責任之際，應提供閱聽眾評估風險的資訊，以清晰明確的文字或圖表解釋風險過程與民眾自我保護的等訊息，減輕民眾的憤怨不安或恐懼。 / In April 2009, Mexico and the Southwestern United States confirmed human cases of Influenza A/H1N1. In a short time, H1N1 influenza was spreading across the rest of the world. People obtain health risk messages mainly through mass media, so what the media cover about H1N1 influenza may do have influences on their audience’s cognition, attitudes, and even behaviors toward this disease. This study has two research purposes. First, it studies how the newspaper media cover H1N1 influenza by analyzing location of article, article type, news length, content about theme, news source, and usage of graphics. Second, it examines the coverage of H1N1 influenza to see if the media focus the facets of risk and uncertainty, present public outrage factors, and offer people the information to evaluate the risks. From this study, we can understand what related issues of H1N1 influenza were presented by four major newspapers in Taiwan, and to the study of coverage of domestic media on infectious diseases this adds a different case. It sampled 1324 H1N1 influenza news reports from Chinese Times, United Daily News, The Liberty Times, and Apple Daily, covered from April 25, 2009 to February 25, 2010. It adopted content analysis to examine these four newspapers about the characteristics of their H1N1 influenza coverage and their risk communication factors. And according to the development of H1N1 influenza in Taiwan, we divided the period into five phases, comparing the similarities and differences of news content among various phases. Results of content analysis showed that the distribution of news theme varies significantly among the phases, though “epidemiological description” is the main theme. There were differences in news theme proportion among the five phases, especially notable difference of the decreasing phase. And that main news source is health officials in all phases. Source bias was more obvious especially during the decreasing phase. In terms of the coverage of public outrage factors, the news content of the four newspapers showed that it has the most outrage factors during H1N1 influenza increasing phase. In the peak and the decline of H1N1influenza contagion, news content of outrage factors decreased significantly. The most presented outrage factors by the four newspapers is the “outrage rhetoric.” Nearly fifty percent of the coverage has “outrage rhetoric” factor. Regarding the coverage of risk explanations in news content, compared by phases, the spreading phase has the highest percentage of risk explanations of H1N1 influenza news, followed by the initial phase and then the epidemic increasing phase. Among the risk explanations presented by the four newspaper, the news group of “process explanations” was found the most, followed by the news categorized of “ practical recommendation,” whereas the news groups of “definitions”, ”risk level explanations” and ”risk comparisons” were seldom mentioned. On the news with graphics, except for Apply Daily, three other newspapers have low usage of graphics. It appears that for H1N1 influenza news it is not common yet to use graphics to explain risks. For those reports with graphs, they are commonly for “risk explanations” and they often mention of messages of “process explanations” and “practical recommendation.” In addition, this study finds that there is significant correlation between articles and graphs when they both present same risk explanations in the news content. To sum up, through this study we found some reports of the four newspapers highlight the risk uncertainty, among which outrage factors are presented with higher exposure of “fear/ panic”, “epidemic out of control”, and “conflicting reports.” On the coverage of 'risk explanations,” it has the most messages about “update the data of H1N1 influenza” and “current epidemic category and area,” whereas it has less messages about “definitions”,” risk level explanations” and ”risk comparisons”. This study used an exploratory framework that posits risk explanations can mitigate negative public reactions by communicating the hazard with clearer articles or graphics. Result of this study recommends when a crisis or risk event happens, media worker should take responsibility of risk communication, and provide accurate and clear risk information to the audience. Thus, it may alleviate the negative public reactions, like outrage, anger, worry, fear, and panic.

Chong, Ka Chun. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2011. / Includes bibliographical references (leaves 125-141). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese.